102213 INTEGRITY FIRE PROTECTION, LLC INDIANA RETAIL TAX EXEMPT Page 1 of 1
cii .it ®f C Ia rmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 102213
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL, INDIANA 46032-2584 VOUCHER,DELIVERY MEMO,PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. • DESCRIPTION
12/5/2018 372005 Repair Sta.44 Backflow
INTEGRITY FIRE PROTECTION, LLC Fire Department
VENDOR 11722 ALLISONVILLE ROAD SHIP 2 Civic Square.
SUITE 103-317 TO Carmel, IN 46032-
FISHERS, IN 46038-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
31656
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 101 General Fund
Account: 43-501.00
1 Each Repair Sta.44 Backflow Preventers&Re-Certify $565.00 $565.00
Sub Total $565.00
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Send Invoice To: "} 4. 1
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Fire Department
2 Civic Square
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Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT I PROJECT PROJECT ACCOUNT I AMOUNT
PAYMENT $565.00
SHIPPING INSTRUCTIONS 'NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
'SHIP PREPAID. AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
*C.O.D.SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
'PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL .. ., ,;.7:
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'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY /
Denise i anon /��^J
TITLE Budget&Accreditation Manager � '
CONTROL NO. 1 02213 CLERK-TREASURER - V